16例先天性心脏病患儿行肺动脉环缩术应用食道超声心动图分析  

Analysis of transesophageal echocardiography in 16 children with congenital heart disease undergoing pulmonary artery banding

作　　者：陈佳丽[1] 赵伟[1] 金肖 陈天兵 刘庆华[1] 俞波[1] 邹勇[1] 陈苏江[1] CHEN Jiali;ZHAO Wei;JIN Xiao;CHEN Tianbing;LIU Qinghua;YU Bo;ZOU Yong;CHEN Sujiang(Cardiac Color Doppler Ultrasound Room,Jiangxi Provincial Children’s Hospital,Jiangxi Province,Nanchang 330038,China)

机构地区：[1]江西省儿童医院心脏彩超室,江西南昌330038

出　　处：《妇儿健康导刊》2024年第16期50-54,78,共6页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

基　　金：江西省卫生健康委科技计划(202410440);江西省药品监督管理局科研项目(2022JS40)。

摘　　要：目的分析16例行肺动脉环缩术(PAB)的先天性心脏病患儿食道超声心动图(TEE)。方法回顾性分析2016年1月至2023年9月于江西省儿童医院行食道超声心动图引导下肺动脉环缩术的16例先天性心脏病患儿的临床资料。通过TEE测量术中肺动脉环缩处内径、肺动脉流速、环缩处压差,结合经皮血氧饱和度,评估环缩效果。结果16例患儿均合并重度肺动脉高压。TEE显示,多发室间隔缺损7例,右心室双出口4例,矫正型大动脉转位1例,完全型大动脉转位3例,三尖瓣下移畸形1例,主动脉弓离断1例,主动脉弓缩窄1例,房间隔缺损1例。患儿全部实施PAB,其中6例死亡,2例放弃治疗,8例接受二次手术。接受二次手术的患儿中,1例实施三次手术,术后恢复良好。结论先天性心脏病合并重度肺动脉高压患儿的病情较危重,多发室间隔缺损居多,且患儿可合并多种心脏结构异常。在PAB的术前、术中使用TEE进行监测,可及时观察并调整肺动脉环缩程度。Objective To analyze the transesophageal echocardiography(TEE)in 16 children with congenital heart disease undergoing pulmonary artery banding(PAB).Methods The clinical data of 16 children with congenital heart disease who underwent TEE guided PAB in Jiangxi Provincial Children’s Hospital from January 2016 to September 2023 were retrospectively analyzed.TEE was used to measure the inner diameter,velocity of pulmonary artery,and pressure difference at the ring contraction during operation,combined with percutaneous blood oxygen saturation to evaluate the effect of ring contraction.Results All 16 cases were complicated with severe pulmonary hypertension.TEE showed that there were 7 cases of multiple ventricular sept al defect,4 cases of double-outlet right ventricle,1 cas e of levo-transposition of great arteries,3 cases of transposition of great arteries,1 cases of Ebstein,1 case of interrupted aortic arch,1 case of coarctation of the aorta,and 1 case of atrial septal defect.All the children underwent PAB,of whom 6 cases died,2 cases gave up treatment,and 8 cases received the second operation.Among the children who received the second operation,1 children underwent the third operation and recovered well after surgery.Conclusion Children with congenital heart disease combined with severe pulmonary hypertension have more serious conditions,multiple ventricular septal defect is most common,and the children can be combined with a variety of cardiac structural abnormalities.TEE can be used to monitor PAB before and during operation to observe and adjust the degree of pulmonary ring contraction in time.

关 键 词：先天性心脏病 肺动脉环缩术 食道超声心动图 

分 类 号：R725.4[医药卫生—儿科]